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Clinical Laboratories and Pathology Groups

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Clinical Laboratories and Pathology Groups

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Becker’s Hospital Review Ranks 16 Healthcare Systems with the Largest Investment in EHR Platforms

Compilation shows US Veterans Administration spent the most at $16B

Clinical laboratory leaders and pathologists will be interested in which hospital systems are making the largest investments in electronic health record (EHR) technologies. Especially considering laboratory information systems (LIS) must interface with these platforms and require extensive reworking when hospitals change their EHRs. For example, hospitals moving to the Epic Systems EHR often require their laboratories to implement the Epic Beaker LIS as well.

According to information sourced by Becker’s Hospital Review, the top 16 hospital systems each spent $500 million or more on EHRs, adding, however, that the information is “not an exhaustive list.” 

Number three on the list is Kaiser Permanente which operates multiple hospitals within its nine healthcare networks across the United States serving 12.5 million members. For that reason, its total investment in EHR technology represents a much larger number of hospitals than the other health systems on the list.

Of the 16 providers on the list, 12 installed EHRs provided by Epic Systems of Verona, Wis. Four of the providers implemented EHRs from Oracle Health (formerly Cerner), North Kansas City, Mo., and Meditech of Westwood, Mass.

“Looking forward, there are many advantages in terms of investing in the future and how we will be aligned with technologies including digital and AI applications,” said pathologist Angelique W. Levi, MD (above), vice chair and director of pathology reference services at Yale School of Medicine, in a news release following a site visit to Geisinger Diagnostic Medicine Institute in Danville, Pa., to see Epic Beaker in operation at Geisinger’s clinical laboratory. “But what we gain immediately—having all the patient information accessible in one place in a linked and integrated fashion—is very important.” (Photo copyright: Yale School of Medicine.)

Provider, EHR, Investment

Becker’s list below shows the total amount invested by the 16 healthcare systems was approximately $38.32 billion. The average EHR implementation cost is $2.39 billion for a large healthcare provider. 

  • US Department of Veteran Affairs, Washington, D.C. (Oracle)    $16 billion.
  • Military Health System, Washington, D.C. (Oracle)                    $5.5 billion.
  • Kaiser Permanente, Oakland, Calif. (Epic)                                 $4.0 billion.
  • Catholic Health Initiatives (CommonSpirit Health),
    Englewood, Colo. (Oracle/Meditech)                                         $1.5 billion.
  • Mayo Clinic, Rochester, Minn. (Epic)                                        $1.5 billion.
  • Mass General Brigham, Somerville, Mass. (Epic)                       $1.2 billion.
  • Northwell Health, New Hyde Park, N.Y. (Epic)                          $1.2 billion.
  • Dignity Health, San Francisco (Oracle/Meditech)                          $1 billion.
  • NYC Health and Hospitals, New York, N.Y. (Epic)                       $1 billion.
  • Sutter Health, Sacramento, Calif. (Epic)                                        $1 billion.
  • NewYork-Presbyterian, New York, N.Y. (Epic)                       $964 million.
  • Providence, Renton, Wash. (Epic)                                            $800 million.
  • Trinity Health, Livonia, Mich. (Epic)                                       $800 million.
  • Duke University Health System, Durham, N.C. (Epic)              $700 million. 
  • AdventHealth, Altamonte Springs, Fla. (Epic)                          $660 million.
  • Memorial Hermann Health System, Houston (Epic)                  $500 million.

Becker’s stated they assembled this list from public sources and that there may be other EHR/hospital contracts with a total cost that also would make the list. It is not common to see a list of what hospitals actually spend to acquire and deploy a new EHR.

Shifting EHR Market

According to KLAS’ 2024 US Acute Care EHR Market Share report, Epic was the only EHR vendor to increase its market share in 2023.

Epic added 153 hospitals to its client base in 2023. Epic’s EHR competitors—Oracle and Meditech—both experienced declines in client retention rate, Healthcare IT News reported based on the KLAS data.

“Both current and prospective large organization customers are drawn to Epic because they see the vendor as a consistently high performer that provides strong healthcare IT [information technology], quality relationships, and the opportunity to streamline workflows and improve clinicians’ satisfaction,” Healthcare IT News said of the KLAS report’s findings.

In a blog post, authors of the KLAS report explained that in 2023 Oracle added specialty hospital clients and Meditech “saw several new sales” which included healthcare systems and independent providers.

In the next few years, the industry is “ripe for disruption. Another vendor could come in and turn everything on its head,” the KLAS blog article concluded. “Even those who choose Epic want to have more competitive options to choose from.”

Preparing for an LIS Change

Clinical laboratory leaders who may be transitioning their LIS during a new EHR installation may learn from colleagues who completed such an implementation. 

In September, Yale School of Medicine in New Haven, Conn., sent a department of pathology team to visit Geisinger Diagnostic Medicine Institute, Danville, Pa. Geisinger had adopted Epic Beaker and has a workflow similar to Yale’s, according to a Yale News article. 

Angelique Levi, MD, vice chair and director of pathology reference services at Yale School of Medicine, who was part of the pathology team, noted that one challenge for labs is addressing “information that’s from many different places when we’re talking about cancer care, prognostic testing, and diagnostics.

“It’s become much more complicated to manage all those data points,” she continued. “Without being on an integrated and aligned system, you’re getting pieces of information from different places, but not the ability to have linked and integrated reports in one spot.”

EHR implementations are among the most labor-intensive, expensive projects undertaken by hospitals. Therefore, it is crucial that clinical laboratory and pathology leaders research and learn why an EHR (and possibly LIS) change is needed, what is expected, and when results will be received.

—Donna Marie Pocius

Related Information:

Most Expensive EHRs, Ranked

Broward Health Transforms Care with Epic Implementation

US Acute Care EHR Market Share 2024

Top 6 EHR Vendors Worldwide

Epic’s EHR Market Share Gains Continue, KLAS Report Shows

US Acute Care EHR Market Share in 2024

Pathology Team Encouraged about Migration to Epic Beaker Laboratory Information System

Forbes Ranks Epic’s Judith Faulkner the Richest Woman in Healthcare in Its 2021 List of 100 Richest Self-Made Women in US

Within the in vitro diagnostics and clinical laboratory space, Bio-Rad’s Alice Schwartz and 23andMe’s Anne Wojcicki also were recognized by Forbes

At $6.5 billion net worth, Forbes, in its 2021 list of the 100 richest self-made women in the US, ranked Judith Faulkner, Chief Executive Officer and founder of Epic Systems Corp., in second place overall. But in the industry of healthcare, she tops the list by far. The next nearest healthcare-related “richest woman” is Alice Schwartz, co-founder of Bio-Rad Laboratories, at $2.9 billion.

Faulkner was surpassed on Forbes’ list only by roofing material magnate Diane Hendricks, co-founder of ABC Supply Co., whose net worth of $11 billion puts her squarely in the top spot.

Richest Self-Made Women in Healthcare

Becker’s Hospital Review highlighted the seven richest “self-made” women who ran healthcare-related companies. They include:

Also listed by Forbes was Anne Wojcicki, CEO and founder of 23andMe, a personal genomics and biotechnology company. Wojcicki’s net worth of $1.1 billion puts her in the 25th position, according to Forbes.

In “Genetic Test Company 23andMe Completes Merger with Richard Branson’s VG Acquisition Corp., Stock Now Trades on NASDAQ,” Dark Daily noted that since the Sunnyvale, Calif. direct-to-consumer (DTC) genetic testing company will now be filing quarterly earnings reports, pathologists and clinical laboratory managers will have the opportunity to learn more about how 23andMe serves the consumer market for genetic types and how it is generating revenue from its huge database containing the genetic sequences from millions of people.

Judith Faulkner and Alice Schwartz

Judith Faulkner (left), founder and CEO of Epic Systems Corp., and Alice Schwartz (right), co-founder of Bio-Rad Laboratories, ranked 2nd and 10th respectively in Forbes’ list of the top 100 richest self-made women. In healthcare, Faulkner ranks 1st and Schwartz 2nd. Clinical laboratory personnel will likely be familiar with Epic Beaker, which, according to Healthcare IT Leaders, “is Epic’s laboratory information system (LIS) for hospitals, clinics, patient service centers, and reference labs. The software supports common workflows for clinical pathology (CP) labs as well as anatomic pathology (AP) labs.”  (Photo copyrights: HIT Consultant/Science History Institute.)

How did Faulkner Make Epic So Epic?

It all started in 1979 when Faulkner and a colleague invested $70,000 to launch Human Services Computing, which became Epic, noted Forbes in “The Billionaire Who Controls Your Medical Records.”

“I always liked making things out of clay. And the computer was clay of the mind. Instead of physical, it was mental,” Faulkner, who is 77, told Forbes.

Company milestones noted by Forbes include:

  • Inking a deal in 2004 with Kaiser Permanente for a three-year, $400-million project.
  • Moving in 2005 to a corporate campus in southern Wisconsin—an “adult Disney World” with the largest underground auditoriums and more “fantastical” buildings.
  • More recently, AdventHealth of Altamonte Springs, Fla., contracted with Epic for a $650 million remote build and installation.

“Epic’s system has tentacles that go out through amazing networks. You can actually help a person get the care they need wherever they need to get it,” AdventHealth’s CEO Terry Shaw told Forbes.

In about two years, Epic plans to launch an artificial intelligence (AI) Electronic Health Record (EHR) documentation tool aimed at transcribing clinician and patient conversations in real-time, EHR Intelligence reported.

However, Epic may face competition from IT startups in areas including ancillary services, where clinical laboratories, for example, are seeking genomic data storage and introducing new genetic tests, according to Becker’s Hospital Review in its report on analysis by CB Insights, titled, “Unbundling Epic: How The Electronic Health Record Market Is Being Disrupted.”

“I think that what will happen is that a few of them will do very well. And the majority of them won’t. “It’s not us as much as the health systems who have to respond to the patient saying, ‘Send my data here,’ or ‘Send my data there,’” Faulkner told Forbes.

Bio-Rad’s Alice Schwartz an IVD ‘Pioneer’

As Faulkner rose to prominence in healthcare IT, Alice Schwartz of Bio-Rad Laboratories found massive success in the in vitro diagnostics industry.

She and her late husband, David, started Bio-Rad with $720 in 1952 in Berkeley, Calif. They were intent on offering life science products and services aimed at identifying, separating, purifying, and analyzing chemical and biological materials, notes the company’s website.

“They were at the right place and at the right time as they became pioneers in the industry,” International Business Times (IBT) stated.

Bio-Rad Laboratories (NYSE:BIO and BIOb) of Hercules, Calif., offers life science research and clinical diagnostic products. The company’s second quarter (Q2) 2021 net sales were $715.9 million, an increase of about 33% compared to $536.9 million in Q2 2020, according to a news release. Its Clinical Diagnostics segment Q2 sales were $380 million, an increase of 34% compared to 2020.

Norman Schwartz, the founders’ son, is Bio-Rad’s Chairman of the Board,

President, and CEO. However, at age 94, Alice Schwartz, the oldest person on Forbes’ richest self-made women list, “has no sign of stopping soon,” IBT reported.

Lists are fun. Medical laboratory and diagnostics professionals may admire such foresight and perseverance. Judith Faulkner and Alice Schwartz are extraordinary examples of innovative thinkers in healthcare. There are others­—many in clinical laboratories and pathology groups.

Donna Marie Pocius

Related Information

Forbes’ Ranking of the Country’s Most Successful Women Entrepreneurs and Executives 2021

Healthcare’s Richest Self-Made Women, Per Forbes

Epic Systems Founder-CEO Judy Faulkner Wields Great Power and Responsibility in Healthcare IT

Unbundling Epic: How the Electronic Health Record Market is Being Disrupted

The Billionaire Who Controls Your Medical Records

Epic in Process of Developing AI EHR Documentation Assistant

Epic’s Revenue Hit $3.3B in 2020; 10 ways the EHR Giant’s Dominance is Opening Doors for Competition

Bio-Rad Reports Second Quarter 2021 Financial Results

Alice Schwartz Net Worth: Oldest, Richest Woman in U.S. is Worth $2.2B

Genetic Test Company 23andMe Completes Merger with Richard Branson’s VG Acquisition Corp; Stock Now Trades on NASDAQ

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